Prostate specific antigen decline in patients with nonmetastatic castration-resistant prostate cancer (nmCRPC)

Best Practice Nordic | Jun 2020 | ASCO20 Virtual |

Results from a post hoc analysis of the SPARTAN Phase III study of apalutamide showed that regardless of genetic subclass, the treatment significantly improved the metastasis-free survival of patients with non-metastatic castration-resistant prostate cancer (nmCRPC). For more than 50% of patients treated with apalutamide, a ≥ 90% reduction in PSA was observed. The results was presented by Fred Saad, professor and Chairman of Urology and Director of GU-oncology at the University of Montreal Hospital Center, at ASCO 2020 in a virtual poster session.  154 patients were treated with apalutamide combined with androgen deprivation therapy. The PSA value was assessed after three, six and twelve months. Tumors were classified at a molecular level and classified into GC (genomic classifier) with high to low average risk, and tumors resistant or sensitive to anti-androgen therapy respectively basal and luminal subtypes. 49% of the patients had a high GC score and 66% had basal subtype. The study demonstrated a fast and persistent PSA reduction and a prolonged metastasis-free survival for all molecular subtypes of patients with nmCRPC in combined apalutamide anti-androgen therapy. The reduction of PSA was greatest and fastest at low and average GC risk as well as with luminal subtypes. The reduction was greatest after six months of treatment. Read the English abstract published on Asco here.